Healthcare Provider Details

I. General information

NPI: 1417126483
Provider Name (Legal Business Name): CHRISTOPHER LOCKWOOD HOBBS EDD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 NEWBURY ST
BOSTON MA
02115
US

IV. Provider business mailing address

6 EVERETT ST
JAMAICA PLAIN MA
02130
US

V. Phone/Fax

Practice location:
  • Phone: 617-437-0447
  • Fax:
Mailing address:
  • Phone: 617-437-0447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3634
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: